Beyond Hyde Amendment

December 27, 2009 6:45 pm

As the health care legislation grinds toward a final vote, abortion rights remain a contentious and perhaps decisive issue. Much depends on whether a restrictive amendment approved by the House of Representatives but defeated in the Senate survives a House-Senate conference and is part of a final bill.

The House passed the Stupak-Pitts amendment Nov. 7 by a vote of 240-194, with Rep. Mike Michaud of Maine’s 2nd District voting aye and Chellie Pingree of the 1st District voting nay. The Senate tabled a similar measure, the Nelson-Hatch amendment, on Dec. 8, with Maine’s two Republican Sens. Olympia Snowe and Susan Collins joining two independents in helping Democrats win by 54-45. Sen. Ben Nelson, a Nebraska Democrat, later won restrictions on abortion payments as part of the health care overhaul legislation.

The measure, heavily supported by right-to-life groups and the U.S. Conference of Catholic Bishops and opposed by Planned Parenthood and other pro-choice groups, amounted to an extension of the Hyde amendment, named for the late Rep. Henry J. Hyde, an Illinois Republican. He introduced it in 1976 as a flat prohibition of payment for abortions from Medicaid funds. Congress has since mandated abortion funding in cases of rape or incest as well as a physical disorder, illness, or injury and has re-enacted the amendment every year.

Rep. Bart Stupak, a Michigan Democrat, insists that his measure is “completely consistent with the Hyde amendments,” as he put it in an article in The New York Times. He wrote: “The amendment does not prevent private plans from offering abortion services, and it does not prohibit women from purchasing abortion coverage with their own money.”

That is technically correct, but pro-choice advocates make a strong case that the effect of the amendment, whether intended or not, would make it even more difficult for a low-income woman to get insurance to pay for an abortion. They show, too, that it would probably cause insurance firms to reduce or eliminate such coverage.

Cecile Richardson, president of the Planned Parenthood Federation of America, questions the Stupak-Pitts assurance that women would be able to purchase a separate single-service rider to cover abortion. She says that no insurance company would offer such a rider. Furthermore, “women do not plan to have unintended pregnancies or medically complicated pregnancies that require ending the pregnancies.”

An analysis of the amendment by members of the Department of Health Policy at the George Washington University Medical Center says that it would influence the insurance industry as a whole. Within six years, under the new health care act, 30 million people would get their health care through the new exchange, according to the Congressional Budget Office. Thus, say the researchers, “it is fair to predict that the entire market for coverage will ultimately be affected as a product tipping point is reached and virtually no supplemental market appears.”

While lawmakers debate provisions of the amendment, what is really at stake in the future is whether government can expand its control over women’s decisions about their reproductive systems.